Dementia is a very debilitating disease, both mentally and physically. It causes an individual to lose much of their cognitive and sensory abilities, especially an understanding of where they are and where they want to go. There are many reasons for this. Some of these changes include decreased contrast sensitivity, lowered visual processing speed and acuity, increased risk of developing eye diseases such as cataracts and glaucoma, visual hallucinations, and changes in color processing (Davis, Weisbeck 2016). In terms of cognitive changes, dementia causes damage to the cognitive map, which is the ability to create a lasting memory of a space or environment (Davis, Weisbeck 2016). All of these changes lower the ability of an individual to properly perceive their environment. A symptom of dementia brought on by all of these factors is wandering, which is a common symptom and early sign of dementia. Though a person suffering from this disease often is not wandering to a specific place, visual cues and other methods of wayfinding can help give someone an idea of where they are. A floor plan should support wandering by providing connecting wandering paths both indoors and outdoors. Visual cues including color, lighting, landmarks, material selection, and signage, can help an individual navigate through the space. Though it is more difficult, people suffering with dementia still have the ability to learn, but they are more dependent on an environment having good means of wayfinding.
Color coding spaces is a common tool for wayfinding, both in memory care and other spaces like hospitals or schools. Because a person with dementia sees colors more muted from their eye diseases, strong colors are recommended. If a floor plan is symmetrical, color coding different sides or wings of a community could help support wayfinding. Color could be used as a major part of the material selection, such as the carpet or walls, or could be used on a smaller scale in the accents. An important space to color code is the residence halls. Painting the doors or the alcove around the door can help a resident identify which room is theirs. Memory boxes outside of doors that invoke a memory or sense of place are another helpful wayfinding tool. Color contrast is a crucial part of the design for memory care. This helps someone with dementia distinguish between different objects. For example, the walls should greatly contrast the flooring, so a person knows where to walk.
Lighting is a crucial factor in the design of memory care communities and can be helpful for wayfinding. Because of the physical impairments of the eyes brought on by dementia, it is very difficult to properly perceive a space. This can often be dangerous to the elderly which is why large amounts of various types of lighting is important. Large windows with open blinds bring natural light into a space. Sunrooms are a common stopping point for dementia residents because of the abundance of light. Chandeliers can become not only a strong feature of a design but can also act as a landmark.
Landmarks are another means of wayfinding and can be a variety of things if they are on a relatively large scale. Landmarks are most commonly located in a lobby or close to the entrance or near a common area like a living or dining room. They help to create stopping points designed to stimulate a memory. Evoking the senses often helps steer a person in that direction such as the sense of hearing or touch (Marquardt, 2011). A feature wall such as a green wall or a mural is memorable and could help residents have an idea of where they are. Water features are a good landmark to use because the sound they make may attract someone towards it.
Cafes, dining areas, and food kiosks give off certain smells, such as popcorn, which can help guide someone in that direction. They are most commonly located in a central or common area where they can be enjoyed by the most residents. The smells from the dining area also have been shown to attract dementia residents which is why they are most commonly located at the core of a floor plan near other common spaces.
Signage is not the best method of wayfinding because people with dementia often lose their ability to read and typically walk with their eyes towards the floor. Using images rather than words can help, though in general signage would be more useful to staff and families of the residents.
Reducing the amount of decision making in an area in turn helps reduce stress and anxiety experienced by residents. A floor plan that limits this, which could include strait wandering paths or hallways and common areas that are centrally located can help limit stress on residents (Rahman, 2013). Dementia may disrupt cognitive and sensory abilities, but it does not entirely eliminate a person’s ability to learn. Making residents more comfortable and familiar with their environments through wayfinding gives them a better quality of life.
References
Davis, R., & Weisbeck, C. (2016, March). Creating a Supportive Environment Using Cues for Wayfinding in Dementia. Retrieved February 28, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5358323/pdf/nihms848816.pdf
Marquardt, G. (2011). Wayfinding for People with Dementia: A Review of the Role of Architectural Design [Abstract]. HERD: Health Environments Research & Design Journal,4(2), 75-90. doi:10.1177/193758671100400207
Rahman, S. (2013, November 25). Living Well with Specific Types of Dementia: A Cognitive Neurology Perspective. Retrieved from http://dementia-wellbeing.org/tag/wayfinding/
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